目的 探讨丹参酮ⅡA磺酸钠联合吗替麦考酚酯对过敏性紫癜肾炎患儿的疗效及对血清转化生长因子-β（TGF-β）及颗粒溶素（GNLY）表达水平的影响。方法 选取聊城市中医医院在2018年3-2019年2月收治的84例过敏性紫癜肾炎患儿为研究对象，按照随机数字表法随机分为观察组与对照组，每组各42例。对照组口服吗替麦考酚酯片，0.5 g/次，2次/d，疗程持续4周。观察组患者在对照组治疗基础上静脉滴注丹参酮ⅡA磺酸钠注射液，小于6岁患者20 mg/次，6至10岁患者25 mg/次，大于10岁患者40 mg/次；加入250 mL生理盐水稀释，1次/d，疗程持续2周后停药，同时继续服用吗替麦考酚酯片2周。治疗4周后观察两组患者疗效。对比两组患者治疗前后的尿常规指标、T淋巴细胞亚群水平、细胞因子水平和治疗过程中的不良反应。结果 治疗后，观察组的总有效率为85.7%，明显高于对照组的总有效率为66.7%（P<0.05）。治疗后，两组患者的尿红细胞、尿蛋白定量较治疗前显著降低（P<0.01），尿微量白蛋白（mAlb）水平较治疗前显著升高（P<0.05）；且观察组尿红细胞与尿蛋白定量水平显著低于对照组（P<0.01），mAlb显著高于对照组（P<0.05）。治疗后，两组患者血清中CD3⁺、CD4⁺、CD4⁺/CD8⁺、NK细胞水平均高于治疗前（P<0.05），且观察组各指标在治疗后明显高于对照组（P<0.05）。治疗后，两组患者血清中白细胞介素-4（IL-4）、TGF-β水平明显降低，γ-干扰素（IFN-γ）、IFN-γ/IL-4、GNLY水平明显升高（P<0.05），且治疗后，观察组患者血清中IL-4、TGF-β水平明显低于对照组，IFN-γ、IFN-γ/IL-4、GNLY水平明显高于对照组（P<0.05、0.01）。两组患者经治疗后，均未发生不可控的不良反应和毒副作用。结论 丹参酮ⅡA磺酸钠联合吗替麦考酚酯治疗过敏性紫癜肾炎患儿可显著提高临床疗效，改善尿常规、T淋巴细胞亚群和细胞因子等相关指标，对过敏性紫癜肾炎患儿的治疗具有十分重要的临床意义。

Objective To investigate the effect of sulfotanshinone sodium combined with mycophenolate mofetil in treatment of children with allergic purpura nephritis and the expression of serumTGF-β and GNLY. Methods 84 children with allergic purpura nephritis in the Traditional Chinese Medicine Hospital of Liaocheng from March 2018 to February 2019 were randomly divided into observation group and control group, 42 cases in each group. Children in the control group were po administered with Mycophenolate Mofetil Tablets, 0.5 g/time, twice daily for 4 weeks. Children in the observation group were iv administered with Sulfotanshinone Sodium Injection on the basis of control group, children younger than 6 years old were received 20 mg/time, patients 6 to 10 years old received 25 mg/time, and patients older than 10 years old received 40 mg/time, 250 mL diluted with normal saline for once daily, the course lasted for 2 weeks, while the Mycophenolate Mofetil Tablets were continued for 2 weeks. After 4 weeks of treatment, the efficacy in two groups was observed. Urine routine indicators, T lymphocyte levels, cytokine levels and adverse reactions before and after treatment were compared between two groups. Results After treatment, the total effective rate of the observation group was 85.7%, which was significantly higher than 66.7% of the control group (P<0.05). After treatment, urine erythrocyte and urine protein quantification in two groups were significantly lower than those before treatment (P<0.01), and mAlb level was significantly higher than that before treatment (P<0.05). And the quantitative level of urine erythrocyte and urine protein in the observation group were significantly lower than those in the control group (P<0.01), but the mAlb was significantly higher than that in the control group (P<0.05). After treatment, the serum levels of CD3⁺, CD4⁺, CD4⁺/CD8⁺ and NK cells in two groups were higher than those before treatment (P<0.05), and the indexes in the observation group were significantly higher than those in the control group after treatment (P<0.05). After treatment, the serum levels of IL-4 and TGF-β were significantly decreased in two groups, while IFN-γ, IFN-γ/IL-4, and GNLY were significantly increased (P<0.05). After treatment, the serum levels of IL-4 and TGF-β levels in the observation group were significantly lower than those in the control group, while the levels of IFN-γ, IFN-γ/IL-4, and GNLY were significantly higher than those in the control group (P<0.05). After treatment, patients in two groups did not occur uncontrollable adverse reactions and toxic side effects. Conclusions sulfotanshinone sodium combined with mycophenolate mofetil in treatment of allergic purpura nephritis patients can significantly improve the clinical curative effect, and improve the indicators of routine urine, T lymphocyte, and cytokines, and treatment of children with allergic purpura nephritis has important clinical significance.

R985